When Sleepaway Camp Becomes an ADHD Medication Vacation

School's out for summer, but what about the meds? Credit: Getty Images

This year, parents of kids going to Eisner and Crane Lake Camps in the Massachusetts Berkshire Mountains can't say they didn't get the memo.

An e-mail went out recently stating, "The Union for Reform Judaism (URJ) Camping system requires that parents fully disclose on the camper medication form all medication that their child has been taking within the last six months. If it is the intention of parents to keep their child off certain routine medication for the summer – especially during their time at camp – we require that this be disclosed as well."

Why the need for this preemptive measure? Because URJ Camps have been burned before.

Apparently, some parents of children with Attention Deficit Hyperactivity Disorder (ADHD) have sent their kids to camp without their medication. On purpose. And without telling anyone at the camp.
The e-mail explains further: "We find that some parents of children with ADD/ADHD feel comfortable giving their children a medication break during the summer, as they believe that camp is more of a relaxed environment than school and that the need for the child to focus is reduced. At camp, children are in fact required to maintain focus at a level often higher than that during the school year. Most activities require campers to be alert, cooperative and task-oriented for much of the 24-hour day – whether on the ropes course, the bike trail, the tennis court or T'fillot (prayer). We want to ensure the children can participate fully and in a way that is safe for both them and those around them."

'Drug Holiday' practices changing

The practice of suspending ongoing medication for a select period of time is nothing new; in fact, it even has a name: Medication Vacation (or, alternately, Drug Holiday), and it's a practice that's been condoned by prescribing doctors themselves.

"In the past, doctors recommended that children take a break from ADHD medication after school, on weekends, and during the summer," states the ADHD Parents Medication Guide, prepared by the American Academy of Child and Adolescent Psychiatry (AAPAC) and the American Psychiatric Association (APA). "Now, many doctors recommend that children stay on their ADHD medication full-time to get the benefits at home and at play."

Why the change of counsel? The guide states that continuing medication outside of school is especially beneficial for teens, as it helps them make decisions about cigarette smoking, substance use and risky behavior.

"Not taking ADHD medication may put your child at risk," the guide warns. "Younger children are at risk for injuries and for having social issues when they are not taking their ADHD medication, and adolescents are more at risk for motor vehicle accidents and other risky behaviors."

'ADHD is a legitimate disability'

Louis Bordman, senior director of URJ Camps Eisner and Crane Lake, says he has unwittingly experienced campers on parent-imposed Medication Vacations. It isn't until he and other staff members notice a pattern of unusually disruptive behavior that they begin to suspect the child's parents have acted disingenuously.

"When there is some type of behavioral challenge or a child gets overly frustrated it causes us to work with the child more closely and investigate more closely," he tells ParentDish. "In some cases, we find that the child doesn't have these frustrations and challenges during the school year and (we think) 'Well, that's odd' and then we find out the reason the child doesn't have those particular challenges at school is because the child may take a particular medication."

According to Bordman, URJ's anti-Medication Vacation stance has been around for a number of years.

"I think there was a myth that campers needed different skills to succeed in camp than they need in school," he says. "But truth be told, they need many of the same levels of interaction and concentration to navigate through the social environment and the schedule of a camp routine."

Child psychiatrist Dr. Larry B. Silver, a clinical professor of psychiatry at Georgetown University Medical Center with more than 30 years of practice and research under his belt, tells ParentDish in a phone interview that he doesn't agree with the practice of drug holidays.

"To me, it's parallel to having a kid that's very nearsighted and not sending him to school with glasses," he says. "ADHD is a legitimate disability. ... If the medication is working and the child needs it, why set the kid up for failure by taking them off the medication?"

Silver says parents who talk about taking breaks usually have not been educated about what the medicine is and how it works.

"They're afraid the medicine is causing harm so they want to get off it whenever possible, rather than seeing it as a positive," he says. "We've been using these medications for over 60 years. They're very safe, they're very effective. For many kids it makes quite a difference in their ability to function in school and among peers."

Parents have their reasons

However, the reasons parents might want to give their kids a drug holiday are both varied and well-founded.

"Some children and teens have difficulty tolerating common side effects of ADHD medication," Dr. Stephen Grcevich, a child and adolescent psychiatrist in Cleveland, tells ParentDish in an e-mail. "Physicians may recommend that parents stop medication for children who struggle to gain weight during the school year. Many tweens and teens complain that they don't feel 'like myself' on ADHD medication. Friends complain that they're too serious on medication. Some kids with anxiety disorders co-occurring with ADHD may become more angry, irritable or emotional on medication."

Then there's the cost of medication.

"During the current economic downturn, families with less expensive health plans often face considerable out-of-pocket expenses for the most commonly prescribed ADHD medications," says Grcevich, president and founder of Family Center by the Falls. "They'll find the money for medication essential to their child's success in school but try to save by skipping weekends and the summer months."

Bordman says he and his camp staff certainly won't (and can't) force parents to comply with their policy, but he does try to explain his side of the story.

"Certainly, I'm not a fan of medicating kids, but when medications work, they help children to thrive," he says. "We need for the campers -- and the campers need for themselves -- to still be able to operate as though they were medicated.

"They're expecting someone other than the parent to be prepared for a child coming that needs to be on medication. And that really creates challenges," he says. "But the greatest challenge is for the child. When the child acts out, their friends don't want to hang out with them and they feel uncomfortable and they beat themselves up (saying), 'Why did I behave that way?' and 'I'm always in trouble.' The parents have taken them off and thrown them right into an extremely intense social environment with rules and guidelines and structure that they need to be able to observe and embrace. And that's a challenge for those kids."

The absence of medication is what "ultimately creates the negative attention," Bordman says. "Then the poor kid absorbs that and then is blamed for his or her behavior, but no, the parents or the physician should be blamed because they're not giving them the help they truly need."

If the parents are adamant, Bordman will make an exception but makes absolutely clear "if there are any challenges, they're going to need to put the child right back on medication."

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ReaderComments (Page 5 of 5)

We learned the hard way that it's important for parents not to close their minds, one way or the other. We refused medication in favor of exploring alternatives for our older daughter, a very bright and creative ADHD child whose individuality we greatly valued. She met with numerous social rejections, and responded with years of defiance and depression, culminating in a breakdown in her 20s, from which she's still struggling. Medication is an essential part of her recovery. Our other daughter, ten years younger, did not have the social problems but struggled in her studies for years, for which we tried tutoring and 504s with little difference. Her self-esteem suffering and depression developing, her doctor recommended ADD medication in her senior year. The results were positive and immediate. It's about brain chemistry-no worse than taking supplements for other deficiencies. I had always been so concerned about the negative stories about medications (and yes, they do need to be monitored closely) but depression is the great disabler -even, sadly, killer - of young adults. I wish we'd consented to medication for our older child, helping her onto a path where the sense of failures and painful rejections would not have ultimately led to the breakdown which has crippled her in adulthood. Keep your minds open to more than you think you know or want to know, is all I'd say. Parenting is tough. God bless you all!

I think it's a fabulous Idea. I believe children are labeled and over medicated and when parents see that there kids do just fine by talking to them, teaching them good behavior, morals and explaining why certain behaviors are acceptable and not acceptable, and by keeping kids active and busy there is little need for so many children to be medicated. Sure there are a few that do better on medication, but for the most part all this kid labeling and medication pumping is simply an excuse, or way to justify there child's poor behavior! It also makes Doctors happy, it keeps kids coming back and that puts money in there pocket and they prescribe medications because they profit from that as well.

Kristen is right. No one should judge parents of ADHD children. Raising one is a daunting task, but without medication, it's a spiral down into a low quality life for the child and parents alike. We tried a 'break' for 3 months without my daughters medication and here's what came back; low grades, moodiness, inappropriate behavior and fighting with family members, untenable oppositional behavior on every level and constant tension in our home. When we returned to her medication? MUCH better performance at school, she joined a dance club, gets along better with her father, brother and me, doesn't talk back as much and seems content. NOW tell me medication is wrong!

I understand that ADHA medication can truly help a child who needs it. I also support a parent's decision to take their children off of this medication if this is what they think is in his best interests after discussing it with their child's doctor. What I have a problem with is sending a child with the inability to focus or control impulses to sleepaway camp without his/her medication if when they have not tried this experiment at home first. My child was a first time camper at a sleepaway camp last year. He was bitten and choked by a child on several occasions. We were told by the camp that he did not instigate the attacks. It was only after the child was finally sent home that the camp was informed that this child had been taken off of his ADHD medication. Perhaps parents should think about the effects on other children before shipping their children off to camp without medication. Children at camp are highly stimulated by activites and probably do not get enough sleep while they are there. This, coupled with the fact that they are now required to live with other children, may be too much of a challenge for some children with ADHD. If parents choose take their children off of their medication, they need to monitor them from home and maybe send them to a day camp first to see how they do. At the very least, they should inform the camp of their actions so that they can be carefully monitored so unsuspecting children are not injured. Anything less is just irresponsible.

As long as the child isn't psychotic, would it not be good to let him figure out how to work through his difficulties without the aid of drugs, whenever his mistakes aren't going to have long-term consequences? Otherwise, aren't the drugs just postponing the maturation that needs to occur sooner or later? Or do we now think the drugs can take the place of actual maturity?

My kid loses her inhibitions when she eats sugar. I could keep her off sugar and never have a struggle. But then when she goes to a birthday party or is served fruit drink at school, she's going to act like a child half her age. So I give her some sugar at "safe" times and apply age-appropriate discipline if she screws up. She can learn! I can't believe so many parents and teachers actually believe their kids cannot (or should not) learn how to behave in the real world.

I am conflicted. My son eats very little when on the medication. I am afraid that when he comes back from camp he will be a walking skeleton. He is only 7. With so much physical activity, I wonder if his hunger will override the medication? I had thought about not giving it to him during the one week camp mainly because of the eating issue. I almost think I should not send him to camp, but I already paid for it.

Lets get real.If you can afford summer camp you can probably afford medication.

The quote:The absence of medication is what "ultimately creates the negative attention," Bordman says. "Then the poor kid absorbs that and then is blamed for his or her behavior, but no, the parents or the physician should be blamed because they're not giving them the help they truly need."

If the parents are adamant, Bordman will make an exception but makes absolutely clear "if there are any challenges, they're going to need to put the child right back on medication."

This is disgusting!The term "medication" needs to be replaced with "treatment"

Medication is just one treatment there are many treatments for ADHD. Look here:www.adhdaction.com/adhd-treatment

Let's be realistic about this. If you send your child to camp without mentioning that you took them off their medication you are doing a disservice to the camp AND your child.

If the camp that your child goes to is not equipped to handle their ADHD then send them to one that is. The are many ADHD specialized camps that would love to have your child.www.adhdaction.com/adhd-summer-camps

Lastly there are some ADHD medications the recommend no intense physical activity while on the drug.

Vacation from Meds : As a school teacher and an adult ADD person, I cannot understand taking a summer vacation from medication. Meds is not an academic strategy, it is a tool in managing your time and your life. Organizing and attending to personal time is just as important as organizing and attending to your school or professional life. If I want to accomplish a project or just be comfortable, I must take my medication.